| NPI | 1649646183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174270) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: VA 2005453868) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2020-03-23 |